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Covering Oregon: Check Out Your Health Insurance Options

Today is the first day you can enroll in health insurance through the Affordable Care Act, and I want to encourage people to consider their options.

First, though, I’d like to cover some basics about what the ACA does:

A bunch more people will be eligible for free health insurance under Medicaid / Oregon Health Plan. Specifically, everyone under 138% of poverty will be eligible. This is a big change since now the only people who are eligible are kids, people on cash welfare (which means you have to make a lot LESS than 100% of poverty), and people who meet income guidelines and are selected at random for a limited number of slots, meaning they essentially win a Oregon Health Plan lottery.

People who make under 400% of poverty but don’t qualify for the Oregon Health Plan will get financial assistance from the Federal government to help them buy insurance unless they already have access to decent insurance through their job.

Insurers won’t be able to deny you insurance or charge you extra because of a pre-existing condition.

It establishes marketplaces where people can compare insurance plans, find out if they’re eligible for financial assistance, etc.

That’s the big picture. There are lots of complicated details, but that’s the big picture. Now more about today.

Cover Oregon is Oregon’s new online marketplace for health insurance. The website shows understandable information about each plan and provides one-stop shopping so you can compare plans and enroll all in one place. The plans on Cover Oregon offer quality coverage, including doctor visits, hospital stays, maternity care, mental health services, emergency room care, prescriptions, preventive care, vision coverage for kids, and more. And again, you might also qualify for financial help, which is only available through Cover Oregon.

There are lots of different opinions about the Affordable Care Act, and you’ve probably seen some of the recent media coverage. But there are lots of reasons to check out www.coveroregon.com:

If you already have insurance, you can use the calculator to find out if you qualify for financial assistance and compare your current plan to see if there’s a better option.

If you own a small business, you can use the small business calculator to find out if your business qualifies for tax credits of up to 50% of health insurance premiums.

If you’re insured but have family or friends who aren’t, you’ll be able to see what the website is like so you can help them.

At the very least, you’ll see what all the fuss is about.

Health insurance you buy through Cover Oregon will be effective January 1, 2014. Since the website is brand new, you’ll be able to compare plans during the first few weeks of October, but if you want to enroll you will need to work with a trained community partner or broker to do so. Or, you can take a look at your options now and enroll later this month on your own through the website. You need to enroll by December 15 for coverage effective January 1, 2014.

Finally, if you’re an adult Oregonian who receives SNAP, you don’t need to go through Cover Oregon or a paper application process to enroll in health insurance. Instead, you should receive a fast-track enrollment form you can return to the Oregon Health Authority.

By the way, I’m really excited about that last part. For the two years before I joined the CityCouncil, I worked for the Oregon Health Authorityand Cover Oregon helping to prepare for implementation of the ACA. We in the states kept on asking the Federal government, “Can we have a fast track through SNAP because SNAP already gives us lots of information about people?” It totally rocks that the answer was ultimately “yes.”

The one thing about the ACA I’m really grumpy about has to do with family coverage. If one member of your family has access to family coverage through his or her employer, and the cost of employee-only coverage isn’t extreme, the law treats the whole family as though they have access to the employer coverage, even if the cost of family coverage is extreme. In this case, you won’t be eligible for financial assistance. That is a real flaw in the way the federal government is interpreting the law, and we in the States jumped up and down about it but didn’t get it fixed.

But all in all, the ACA is going to be a big help to a lot of people. Check it out.